机器人辅助达芬奇 X 肠系膜下动脉结扎治疗 II 型内漏后吲哚菁绿结肠灌注演示。
Indocyanine green colonic perfusion demonstration following robotic da Vinci X inferior mesenteric artery ligation for the treatment of type II endoleak.
机构信息
Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK.
Lancaster Medical School, Furness College, Lancaster University, Lancaster, UK.
出版信息
Int J Med Robot. 2022 Aug;18(4):e2407. doi: 10.1002/rcs.2407. Epub 2022 Apr 23.
BACKGROUND
We describe the technical operative details of the robotic repair of a type II endoleak (T2E) following endovascular abdominal aortic aneurysm repair (EVAR). We demonstrate that indocyanine green (ICG) can be used intra-operatively to demonstrate perfusion of the colon following ligation of the inferior mesenteric artery (IMA) vessel feeding the aneurysm sac.
METHODS
A 74-year old male underwent EVAR for a 5.8 cm infra-renal abdominal aortic aneurysm using an E-Tegra, Jotec Device (JOTEC Gmb, Lotzenäcker 23,D-72379 Hechingen). Surveillance contrast CT (CTA) over the ensuing 30 months confirmed progressive sac expansion.
RESULTS
ICG confirmed colonic perfusion via the marginals after IMA ligation. Total operative time 56 min < 50 mls blood loss and 1-day hospital stay. 3-month follow-up: CTA and ultrasound demonstrated complete resolution of T2E and adequately perfused colon.
CONCLUSION
A total robotic approach can be performed safely with intra-operative ICG used to demonstrate colonic perfusion as an added safety measure.
背景
我们描述了机器人修复血管内腹主动脉瘤修复（EVAR）后 II 型内漏（T2E）的技术操作细节。我们证明，吲哚菁绿（ICG）可在术中用于证明结扎供应动脉瘤囊的肠系膜下动脉（IMA）血管后结肠的灌注。
方法
一名 74 岁男性因 5.8cm 肾下型腹主动脉瘤接受 EVAR 治疗，使用 E-Tegra，Jotec 器械（JOTEC Gmb，Lotzenäcker 23，D-72379 Hechingen）。随后的 30 个月的监测对比 CT（CTA）证实了囊的进行性扩张。
结果
IMA 结扎后，ICG 通过边缘确认了结肠的灌注。总手术时间 56 分钟<50ml 失血量和 1 天住院时间。3 个月随访：CTA 和超声显示 T2E 完全缓解，结肠灌注充足。
结论
可以安全地进行全机器人方法，并使用术中 ICG 来证明结肠灌注作为附加的安全措施。
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